benm I wore a medical heart monitor briefly due to some temporary heart anomalies. I would like to have an always-running ECG in a wearable device and now days many premium smartwatches have FDA approved ECGs. I would like someone's advice on what the best experiences is as of 2025 for a smartwatch with ECG (I am in the US). Right now I do not have Google Play Services on my Pixel 9a and I do not have a secondary profile. But medical concerns for me are a higher priority than privacy concerns. I am aware of Gadgetbridge but based on preliminary searching I wasn't able to find an FDA approved ECG watch that Gadgetbridge supports. If installing Google Play Services is the best option, I will do it, but I want to see what is out there first. And I want to make sure that if I do install Play Services that it will actually work, and what I need to do to minimize the privacy hit.
had a similar concern after using a heart monitor for a short time, so I get what you’re looking for.
For 2025, the easiest ECG smartwatch options in the US are:
Apple Watch → best ECG experience, but only really works well with iPhone
Samsung Galaxy Watch → good ECG on Android, but needs Google Play Services
Pixel Watch → also works, but again depends on Google services being installed
Since you’re on a Pixel 9a without Play Services, that’s the main issue. Most FDA-approved ECG features on Android watches rely on Google apps to run properly.
If your health monitoring is the priority, you may need to install Google Play Services (even just basic setup) so the ECG feature actually works. You can still reduce privacy impact by limiting permissions and disabling things you don’t need.
Also keep in mind: smartwatch ECG is not continuous like a hospital monitor—it only checks your heart when you take a reading.
Some people also use platforms like FibriArt to help track and organize heart-related data over time, especially when they want a clearer long-term view instead of just one-off readings.
In short: Samsung or Pixel Watch + Google services is the most practical Android setup right now for ECG.